You are on page 1of 29

Declaration of Assets and Liabilities

Year2023-2024

I, TARUN KUMAR PANDEY son/daughter/wife of, shambhu Nath Pandey


aged. ,belonging to BIHAR GOVERMENT service and presently working as BLOCK PANCHAYAT
RAJ OFFICER in Chakia Block East Champaran
give herein below the details of the assets (immovable, movable, bank balance, etc.) of myself,
my spouse and dependants*:
A. Details of movable assets
(Assets in joint name indicating the extent of joint
given) ownership will also have to be

Sr Description Self
.
N
o.
(i) Cash
500
(ii) Deposits in
Banks,
Financial
Institutions 5,84,000
And Non-
Banking
Financial
Companies
(iii Bonds,
) Debentures
and Shares in Nil
companies

(iv Other
) financial
institutions, Nil
NSS, Postal
Savings, LIC
Policies, etc

(v) Motor
Vehicles
(details of Nil
make, etc.)
(vi Jewellery
) (give details Nil
of weight and
value)

(vii Other assets,


) such as Nil
values
of
claims /
interests

Note: Value of Bonds / shares / Debentures as per the latest market value in Stock Exchange in respect
of listed companies and as per books in the case of non listed companies should be given.
* Dependant here means a person substantially dependent on the income of the employee.
B. Details of Immovable assets
[Note: Properties in joint ownership indicating the extent of joint ownership will
also have to be indicated]
Sr Description S Spou Depen Depen Dependa
. e se dan t- dan t- nt-
N lf
Name 1 2 3
o. (S) Name Name Etc.
Name
(i) Agricultural Land
- Location(s) 2 acre
- Survey number(s)
- Extent
(Total
measurement
)
-Current market value
(ii) Non-Agricultural Land
- Location(s)
- Survey number(s) 1500sq foot
- Extent
(Total
measurement
)
-Current market value
(iii) Buildings (Commercial
and residential)
Location(s)
- Survey Nil
/door
number(s)
- Extent
(Total
measurement
)
- Current
market value
(iv) Houses / Apartments,
etc.
- Location(s)
- Survey Nil
/door
number(s)
- Extent
(Total
measurement
)
- Current
market value
(v) Others (such as
interest in property)

(2) I give herein below the details of my liabilities / over dues to public financial institutions
and government dues:-
[Note : Please give separate details for each item)

S Description Name & address of Amount


r Bank / Financial outstanding as
. Institutions(s) /
N Department (s) on
o …………………..
.
(a) (i) Loans from Banks Nil

(ii) Loans from financial Nil


institutions
(iii) Government Dues:
(a) dues to departments
dealing with government Nil
accommodation
(b) dues to departments
dealing with supply of Nil.
water
(c) dues to departments
dealing with supply of Nil
electricity
(d) dues to departments
dealing with telephones Nil
(e) dues to departments
dealing with government Nil
transport (including
aircraft and helicopters)
(f) Other dues, if any
Nil.
(b) (i) Income Tax including
surcharge [Also indicate
the assessment year upto Nil
which Income Tax Return
filed. Give also Permanent
Account Number (PAN)]

(ii) Wealth Tax [Also


indicate the assessment Nil
year upto which Wealth
Tax return filed.]
(iii) Sales Tax [Only in
case of proprietary Nil
business]
(iv) Property Tax

C. Personal Detail

GPF/CPF/PRAN No.
Gender :- M
Date of Birth
(DD/MM/YYYY)
:-31/12/1998

(A/B/C) :
Class/Group

:-Bihar panchayat
service

Cadre :-
block
panch
ayat
raj
officer

Home District :- belief.


chapra saran

I hereby declare knowledge and that the above details are true to the best of
my

Signature ------------------------------------

Place:.................. Designation:.

Date:....................... Department
Note: Please sign each page of the declaration. Asset declaration form must be in A4 size
white paper with computer typed (single side) in prescribed format.
Declaration of Assets and Liabilities

Year2022-2023

I,BABULAL RAM, son/daughter/wife of,LATE – SAUKHI RAM aged. 57 years,belonging to


COLLECTORATE service and presently working as ASSISTANT, BLOCK OFFICE BANKATWA
give herein below the details of the assets (immovable, movable, bank balance, etc.) of myself, my
spouse and dependants*:
A. Details of movable assets
(Assets in joint name indicating the extent of joint
given) ownership will also have to be

Sr Description Self Spouse Depen Depend Depen


. Name(S dan t- ant- 2 dan
N ) 1 Name t-3
o. Name Etc.
Name

(i) Cash 5000 NIL NIL NIL NIL

(ii) Deposits in 50000 DIED 650000 NIL NIL


Banks,
Financial
Institutions
And Non-
Banking
Financial
Companies
(iii Bonds, NIL NIL NIL NIL NIL
) Debentures
and Shares in
companies

(iv Other NIL NIL NIL NIL NIL


) financial
institutions,
NSS, Postal
Savings, LIC
Policies, etc

(v) Motor NIL NIL MOTOR MOTOR NIL


Vehicles CYCLE CYCLE
(details of
make, etc.)
(vi Jewellery NIL NIL 10 Gm Gold 10 Gm Gold NIL
) (give details Rs 65000 Rs 65000
of weight and Silver 150 Silver 200 Gm
value) Gm Rs 55000
Rs 50000

(vii Other assets, NIL NIL NIL NIL NIL


) such as
values
of
claims /
interests

Note: Value of Bonds / shares / Debentures as per the latest market value in Stock Exchange in respect of
listed companies and as per books in the case of non listed companies should be given.
* Dependant here means a person substantially dependent on the income of the employee.
D. Details of Immovable assets
[Note: Properties in joint ownership indicating the extent of joint ownership will
also have to be indicated]
Sr Description S Spou Depen Depen Dependa
. e se dan t- dan t- nt-
N lf
Name 1 2 3
o. (S) Name Name Etc.
Name
(i) Agricultural Land NIL 10 ½ Katha 1 ½ Katha 1 ½ Katha NIL
- Location(s) 25.60 Lakh 15 Lakh 15 Lakh
- Survey number(s)
- Extent
(Total
measurement
)
-Current market value
(ii) Non-Agricultural Land NIL NIL NIL NIL NIL
- Location(s)
- Survey number(s)
- Extent
(Total
measurement
)
-Current market value
(iii) Buildings (Commercial 12 Dhur NIL NIL NIL NIL
and residential) Kbap rail with
Location(s) Brike
- Survey
/door
number(s)
- Extent
(Total
measurement
)
- Current
market value
(iv) Houses / Apartments, NIL NIL NIL NIL NIL
etc.
- Location(s)
- Survey
/door
number(s)
- Extent
(Total
measurement
)
- Current
market value
(v) Others (such as NIL NIL NIL NIL NIL
interest in property)

(2) I give herein below the details of my liabilities / over dues to public financial institutions
and government dues:-
[Note : Please give separate details for each item)

S Description Name & address of Amount


r Bank / Financial outstanding as
. Institutions(s) /
N Department (s) on
o …………………..
.
(a) (i) Loans from Banks NIL NIL
(ii) Loans from financial NIL NIL
institutions
(iii) Government Dues: NIL NIL
(a) dues to departments
dealing with government
accommodation
(b) dues to departments NIL NIL
dealing with supply of
water
(c) dues to departments NIL NIL
dealing with supply of
electricity
NIL NIL
(d) dues to departments NIL NIL
dealing with telephones
(e) dues to departments NIL NIL
dealing with government
transport (including
aircraft and helicopters)
(f) Other dues, if any NIL NIL

(b) (i) Income Tax including BLRPR7380F NIL


surcharge [Also indicate
the assessment year upto
which Income Tax Return
filed. Give also Permanent
Account Number (PAN)]

(ii) Wealth Tax [Also NIL NIL


indicate the assessment
year upto which Wealth
Tax return filed.]
(iii) Sales Tax [Only in NIL NIL
case of proprietary
business]
(iv) Property Tax NIL NIL

E. Personal Detail

GPF/CPF/PRAN No. :- MOT/RDD-547

Gender :- M
Date of Birth
1 (DD/MM/YYYY)
:- 5
0

(A/B/C) :
Class/Group

:-

Cadre :- 3 R
D

(Full Name e.g. B.A.S.-Bihar Administrative Service, B.S.S.- Bihar

Secretariat Service etc.)

Home District :- EAST CHAMPARAN

I hereby declare knowledge and that the above details are true to the best of
belief. my

Signature ------------------------------------

Name of Employee: BABULAL RAM

Place:. BANKATWA Designation:. ASSISTANT

Date: 23-01-2023 Department Rural Devlopment Department


Note: Please sign each page of the declaration. Asset declaration form must be
in A4 size white paper with computer typed (single side) in prescribed
format.
Declaration of Assets and Liabilities

Year2022-2023

I,SHILANATH JHA, son/daughter/wife of,LATE – SHREE RAMJEE JHA aged. 55


years,belonging to BIHAR STATE GOVERNMENT service and presently working as BAO,
BLOCK OFFICE BANKATWA
give herein below the details of the assets (immovable, movable, bank balance, etc.) of
myself, my spouse and dependants*:
A. Details of movable assets
(Assets in joint name indicating the extent of joint
given) ownership will also have to be

Sr Description Self Spouse Depen Depend Depen


. Name(S dan t- ant- 2 dan
N ) 1 Name t-3
o. Name Etc.
Name

(i) Cash 50000 5000 10000 NIL NIL

(ii) Deposits in 60000 10000 NIL NIL NIL


Banks,
Financial
Institutions
And Non-
Banking
Financial
Companies
(iii Bonds, NIL NIL NIL NIL NIL
) Debentures
and Shares in
companies

(iv Other 100000 NIL NIL NIL NIL


) financial 45000
institutions, 300000
NSS, Postal
Savings, LIC
Policies, etc

(v) Motor 60000 NIL NIL NIL NIL


Vehicles
(details of
make, etc.)
(vi Jewellery 20 GRAM GOLD NIL NIL NIL NIL
) (give details 500 GRAM SILVER
of weight and
value)

(vii Other assets, SWIFT NIL NIL NIL NIL


) such as 600000
values
of
claims /
interests

Note: Value of Bonds / shares / Debentures as per the latest market value in Stock Exchange in
respect of listed companies and as per books in the case of non listed companies should be given.
* Dependant here means a person substantially dependent on the income of the employee.
B. Details of Immovable assets
[Note: Properties in joint ownership indicating the extent of joint ownership will
also have to be indicated]
Sr Description S Spou Depen Depen Dependa
. e se dan t- dan t- nt-
N lf
Name 1 2 3
o. (S) Name Name Etc.
Name
(i) Agricultural Land 10/2 KATHA NIL NIL NIL NIL
- Location(s) PATERNAL
- Survey number(s) 500000
- Extent
(Total
measurement
)
-Current market value
(ii) Non-Agricultural Land 1 KATHA NIL NIL NIL NIL
- Location(s) PATERNAL
- Survey number(s) 500000
- Extent
(Total
measurement
)
-Current market value
(iii) Buildings (Commercial NIL NIL NIL NIL NIL
and residential)
Location(s)
- Survey
/door
number(s)
- Extent
(Total
measurement
)
- Current
market value
(iv) Houses / Apartments, NIL NIL NIL NIL NIL
etc.
- Location(s)
- Survey
/door
number(s)
- Extent
(Total
measurement
)
- Current
market value
(v) Others (such as NIL NIL NIL NIL NIL
interest in property)

(2) I give herein below the details of my liabilities / over dues to public financial institutions
and government dues:-
[Note : Please give separate details for each item)

S Description Name & address of Amount


r Bank / Financial outstanding as
. Institutions(s) /
N Department (s) on
o …………………..
.
(a) (i) Loans from Banks SNN DICATE BANK 100000
(ii) Loans from financial SBI DHAKA 600000
institutions
(iii) Government Dues: NIL NIL
(a) dues to departments
dealing with government
accommodation
(b) dues to departments NIL NIL
dealing with supply of
water
(c) dues to departments NIL NIL
dealing with supply of
electricity
NIL NIL
(d) dues to departments NIL NIL
dealing with telephones
(e) dues to departments NIL NIL
dealing with government
transport (including
aircraft and helicopters)
(f) Other dues, if any NIL NIL

(b) (i) Income Tax including AGSPJ5455G NIL


surcharge [Also indicate
the assessment year upto
which Income Tax Return
filed. Give also Permanent
Account Number (PAN)]

(ii) Wealth Tax [Also NIL NIL


indicate the assessment
year upto which Wealth
Tax return filed.]
(iii) Sales Tax [Only in NIL NIL
case of proprietary
business]
(iv) Property Tax NIL NIL

C. Personal Detail

GPF/CPF/PRAN No. :- SIT/AGR-500

Gender :- M
Date of Birth
0 (DD/MM/YYYY)
:- 8
0

(A/B/C) :
Class/Group

:-

Cadre :-
BAO

(Full Name e.g. B.A.S.-Bihar Administrative Service, B.S.S.- Bihar

Secretariat Service etc.)

Home District :- SITAMARHI

I hereby declare knowledge and that the above details are true to the best of
belief. my

Signature ------------------------------------

Name of Employee: SHILANATH JHA

Place:. BANKATWA Designation:. BAO

Date------------- Department AGRICULTURE


Note: Please sign each page of the declaration. Asset declaration form must be
in A4 size white paper with computer typed (single side) in prescribed
format.
Declaration of Assets and Liabilities

Year-2022-23

I, SHASHI BHUSHAN KUMAR, son of,RAM LAL THAKUR aged 31 years,belonging to BIHAR
GOVERMENT service and presently working as ASSISTANT, BLOCK OFFICE BANKATWA
give herein below the details of the assets (immovable, movable, bank balance, etc.) of
myself, my spouse and dependants*:
A. Details of movable assets
(Assets in joint name indicating the extent of joint
given) ownership will also have to be

Sr Description Self Spouse Depen Depend Depen


. Name(S dan t- ant- 2 dan
N ) 1 Name t-3
o. Name

(i) Cash 5,000/- NIL NIL NIL NIL

(ii) Deposits in
Banks, 10,12,000/-
Financial
Institutions NIL NIL NIL
And Non- NIL
Banking
Financial
Companies
(iii Bonds,
) Debentures
and Shares in NIL NIL NIL NIL NIL
companies

(iv Other
) financial
institutions, LIC NIL NIL NIL NIL
NSS, Postal 53,000/- Yearly
Savings, LIC
Policies, etc

(v) Motor
Vehicles
(details of HERO SPLENDER NIL NIL NIL NIL
make, etc.) MOTOR CYCLE
25,000/-
(vi Jewellery
) (give details GOLD 70 gm
of weight and NIL NIL NIL NIL
value) SILVER 200 gm

(vii Other assets,


) such as NIL NIL NIL NIL NIL
values
of
claims /
interests

Note: Value of Bonds / shares / Debentures as per the latest market value in Stock Exchange in
respect of listed companies and as per books in the case of non listed companies should be given.
* Dependant here means a person substantially dependent on the income of the employee.
B. Details of Immovable assets
[Note: Properties in joint ownership indicating the extent of joint ownership will
also have to be indicated]
Sr Description Sel Spou Depen Depen Dependa
. f se dan t- dan t- nt-
N Name 1 2 3
o. (S) Name Name Etc.
Name
(i) Agricultural Land
- Location(s)
- Survey number(s) NIL NIL NIL NIL NIL
- Extent
(Total
measurement
)
-Current market value
(ii) Non-Agricultural Land
- Location(s)
- Survey number(s) NIL NIL NIL NIL NIL
- Extent
(Total
measurement
)
-Current market value
(iii) Buildings (Commercial
and residential)
Location(s)
- Survey NIL NIL NIL NIL NIL
/door
number(s)
- Extent
(Total
measurement
)
- Current
market value
(iv) Houses / Apartments,
etc.
- Location(s)
- Survey
NIL NIL NIL NIL NIL
/door
number(s)
- Extent
(Total
measurement
)
- Current
market value
(v) Others (such as NIL NIL NIL NIL NIL
interest in property)

(2) I give herein below the details of my liabilities / over dues to public financial institutions
and government dues:-
[Note : Please give separate details for each item)

S Description Name & address of Amount


r Bank / Financial outstanding as
. Institutions(s) /
N Department (s) on 31.12.2022
o
.
(a) (i) Loans from Banks NIL NIL
(ii) Loans from financial
institutions LIC HFL 19,00,000/-
(iii) Government Dues: NIL NIL
(a) dues to departments
dealing with government
accommodation
(b) dues to departments NIL NIL
dealing with supply of
water
(c) dues to departments NIL NIL
dealing with supply of
electricity
(d) dues to departments NIL NIL
dealing with telephones
(e) dues to departments NIL NIL
dealing with government
transport (including
aircraft and helicopters)
(f) Other dues, if any
NIL
NIL
(b) (i) Income Tax including
surcharge [Also indicate
the assessment year upto
which Income Tax Return DAVPK2258A NIL
filed. Give also Permanent
Account Number (PAN)]

(ii) Wealth Tax [Also NIL NIL


indicate the assessment
year upto which Wealth
Tax return filed.]
(iii) Sales Tax [Only in NIL NIL
case of proprietary
business]
(iv) Property Tax

C. Personal Detail :-

GPF/CPF/PRAN No. :- 111108207499

Gender :- M
Date of Birth
(DD/MM/YYYY)
:- 2
8
(A/B/C) :
Class/Group
C
:-

Cadre LDC (COLLECTORATE)


:-
(Full Name e.g. B.A.S.-Bihar Administrative Service, B.S.S.- Bihar

Secretariat SeArvice etc.)

Home District :- EAST CHAMPARAN

Signature .............................................

Name of Employee: - SHASHI BHUSHAN KUMAR

Place:.................. Designation:- LOWER DIVISION CLERK

Date:...................... Department :- GENERAL ADMINISTRATION


DEPARTMENT
Note: Please sign each page of the declaration. Asset declaration form must be
in A4 size white paper with computer typed (single side) in prescribed
format.

Declaration of Assets and Liabilities

Year-2022-23

I, RAJARAM PASWAN, son of,LATE JHAGRU PASWAN aged 49 years,belonging to RURAL


DEVELOPMENT DEPARTMENT service and presently working as RDO CUM BDO
BANKATWA, EAST CHAMPARAN give herein below the details of the assets (immovable, m.
ovable, bank balance, etc.) of myself, my spouse and dependants*:
A. Details of movable assets
(Assets in joint name indicating the extent of joint
given) ownership will also have to be

Sr Description Self Spouse Depen Depend Depen


. Name(S dan t- ant- 2 dan
N ) 1 Name t-3
o. Name

(i) Cash 25000 35000 NIL NIL NIL

(ii) Deposits in 1,35000 1,35000


Banks,
Financial
Institutions NIL
And Non- 40,000 NIL
Banking
Financial
Companies
(iii Bonds,
) Debentures
and Shares in NIL NIL NIL NIL NIL
companies

(iv Other
) financial
institutions, LIC (SBI) NIL NIL NIL NIL
NSS, Postal 300000
Savings, LIC
Policies, etc

(v) Motor
Vehicles
(details of MOTER CYCLE-BR 30- NIL NIL NIL NIL
make, etc.) 3995 YEAR 2009
15,000/-
(vi Jewellery
) (give details GOLD 45 gm
of weight and GOLD 95 gm NIL NIL NIL
value) 252000 5,32000
SILVER 300
GM
15000
(vii Other assets,
) such as NIL NIL NIL NIL NIL
values
of
claims /
interests

Note: Value of Bonds / shares / Debentures as per the latest market value in Stock Exchange in
respect of listed companies and as per books in the case of non listed companies should be given.
* Dependant here means a person substantially dependent on the income of the employee.
B. Details of Immovable assets
[Note: Properties in joint ownership indicating the extent of joint ownership will
also have to be indicated]
Sr Spous Depen Depen Dependa
. S e nt-
Description el dan t- dan t-
N Name( 1 2 3
f Etc.
o. S) Name Name Name
Agricultural Land
- Location(s)
- Survey number(s)
(i) - Extent
(Total 10 DECIMAL NIL NIL NIL NIL
measurement
)
-Current market value
Non-Agricultural Land
- Location(s)
- Survey number(s)
(ii) - Extent
(Total NIL NIL NIL NIL NIL
measurement
)
-Current market value
Buildings (Commercial
and residential)
Location(s)
- Survey
/door
number(s)
(iii)
- Extent
(Total NIL NIL NIL NIL NIL
measurement
)
- Current
market value
Houses / Apartments,
etc.
- Location(s)
- Survey
/door
THALKHAPU
number(s)
(iv) R
- Extent NIL KHATA NO -
(Total 368 NIL NIL NIL
measurement KESARA NO-
) 816
- Current 0.4 DECIMAL
market value
Others (such as
(v) NIL NIL NIL NIL NIL
interest in property)

(2) I give herein below the details of my liabilities / over dues to public financial institutions
and government dues:-
[Note : Please give separate details for each item)

S Description Name & address of Amount


r Bank / Financial outstanding as
. Institutions(s) /
N Department (s) on 31.12.2022
o
.
(a) (i) Loans from Banks HOUSE LOAN 722000
CAR LOAN 338000
(ii) Loans from financial
institutions
(iii) Government Dues: NIL NIL
(a) dues to departments
dealing with government
accommodation
(b) dues to departments NIL NIL
dealing with supply of
water
(c) dues to departments NIL NIL
dealing with supply of
electricity
(d) dues to departments NIL NIL
dealing with telephones
(e) dues to departments NIL NIL
dealing with government
transport (including
aircraft and helicopters)
(f) Other dues, if any
75,000
NIL
(b) (i) Income Tax including
surcharge [Also indicate
the assessment year upto
which Income Tax Return 2022-23 NIL
filed. Give also Permanent RS-42, 767
Account Number (PAN)] AQAPP6022H
(ii) Wealth Tax [Also NIL NIL
indicate the assessment
year upto which Wealth
Tax return filed.]
(iii) Sales Tax [Only in NIL NIL
case of proprietary
business]
(iv) Property Tax

C. Personal Detail :-

GPF/CPF/PRAN No. :- SIT/EDN-8992

Gender :- M
Date of Birth
(DD/MM/YYYY)
:- 0
5
(A/B/C) :
Class/Group
B
:-

Cadre :- RURAL DEVELOPMENT DEPARTMENT


(Full

Name e.g. B.A.S.-Bihar Administrative Service, B.S.S.- Bihar

Secretariat SeArvice etc.)

Home District :- SEOHAR

Signature .............................................

Name of Employee: - RAJARAM PASWAN

Place: BANKATWA Designation:- RDO-CUM-BDO

Date:...................... Department :- RURAL DEVELOPMENT DEPARTMENT


Note: Please sign each page of the declaration. Asset declaration form must be
in A4 size white paper with computer typed (single side) in prescribed
format.
Declaration of Assets and Liabilities

Year-2022-23

I, MAHIPAL MISHRA, son of,LATE VISHWANATH MISRHA aged 46 years,belonging to


EDUCATION DEPARTMENT service and presently working as ASST. TEACHER G.U.M.S
KUDARKAT, BANKATWA give herein below the details of the assets (immovable, m.
ovable, bank balance, etc.) of myself, my spouse and dependants*:
A. Details of movable assets
(Assets in joint name indicating the extent of joint
given) ownership will also have to be

Sr Description Self Spouse Depen Depend Depen


. Name(S dan t- ant- 2 dan
N ) 1 Name t-3
o. Name ADITYA RIYA
BINDI RAJ
GARGI
KUMARI
(i) Cash
50,000/- 10,000/- NIL NIL NIL
(ii) Deposits in
Banks,
Financial NIL NIL NIL NIL
Institutions 22,11,000/-
And Non-
Banking
Financial
Companies
(iii Bonds,
) Debentures
and Shares in 6000/- Monthly NIL NIL NIL NIL
companies

(iv Other
) financial
institutions, LIC NIL NIL NIL NIL
NSS, Postal 5,00,000/-
Savings, LIC RD
Policies, etc 5250/- Monthly

(v) Motor
Vehicles
(details of MOTER CYCLE- NIL NIL NIL NIL
make, etc.) 50,000/-

(vi Jewellery
) (give details GOLD 45 gm
of weight and GOLD 95 gm NIL NIL NIL
value) 252000 5,32000
SILVER 300
GM
15000
(vii Other assets,
) such as NIL NIL NIL NIL NIL
values
of
claims /
interests

Note: Value of Bonds / shares / Debentures as per the latest market value in Stock Exchange in
respect of listed companies and as per books in the case of non listed companies should be given.
* Dependant here means a person substantially dependent on the income of the employee.
B. Details of Immovable assets
[Note: Properties in joint ownership indicating the extent of joint ownership will
also have to be indicated]
Spouse Depen Depen Depend
Sr Name(S) dan t- dant- an t-
. S
Description el 1 2 3
N f BINDI Name Name
o. RIYA
KUMARI GARGI ADITYA
RAJ
Agricultural Land
- Location(s)
- Survey number(s)
(i) - Extent PATRIC LAND
(Total 90 DISMIL
500 DISMIL NIL NIL NIL
measurement RS 1100000
RS 1500000
)
-Current market value
Non-Agricultural Land
- Location(s)
- Survey number(s) 50 DISMIL
(ii) - Extent
(Total RS
NIL NIL NIL NIL
measurement 600000
)
-Current market value
Buildings (Commercial
and residential)
Location(s)
- Survey PATRIC
/door BUILDING
number(s)
(iii) 20 DISMIL
- Extent
(Total NIL NIL NIL NIL
RS 1500000
measurement
)
- Current
market value
Houses / Apartments,
etc.
- Location(s)
- Survey
/door
number(s)
(iv)
- Extent NIL
(Total NIL NIL NIL NIL
measurement
)
- Current
market value
Others (such as
(v) NIL NIL NIL NIL NIL
interest in property)

(2) I give herein below the details of my liabilities / over dues to public financial institutions
and government dues:-
[Note : Please give separate details for each item)

S Description Name & address of Amount


r Bank / Financial outstanding as
. Institutions(s) /
N Department (s) on 31.12.2022
o
.
(a) (i) Loans from Banks NIL NIL
(ii) Loans from financial NIL NIL
institutions
(iii) Government Dues: NIL NIL
(a) dues to departments
dealing with government
accommodation
(b) dues to departments NIL NIL
dealing with supply of
water
(c) dues to departments NIL NIL
dealing with supply of
electricity
(d) dues to departments NIL NIL
dealing with telephones
(e) dues to departments NIL NIL
dealing with government
transport (including
aircraft and helicopters)
(f) Other dues, if any
NIL
NIL
(b) (i) Income Tax including
surcharge [Also indicate
the assessment year upto
which Income Tax Return PAN - AKPPM8185P AY 2022-23
filed. Give also Permanent RS 57360
Account Number (PAN)]

(ii) Wealth Tax [Also NIL NIL


indicate the assessment
year upto which Wealth
Tax return filed.]
(iii) Sales Tax [Only in NIL NIL
case of proprietary
business]
(iv) Property Tax NIL NIL

C. Personal Detail :-

GPF/CPF/PRAN No. :- HJP/EDN-8383

Gender :- M
Date of Birth
(DD/MM/YYYY)
:- 0
1
(A/B/C) :
Class/Group
C
:-

Cadre :- DISTRICT EDUCATION DEPARTMENT


(Full

Name e.g. B.A.S.-Bihar Administrative Service, B.S.S.- Bihar

Secretariat SeArvice etc.)

Home District :- EAST CHAMPARAN

Signature .............................................

Name of Employee: - MAHIPAL MISHRA

Place: BANKATWA Designation:- ASST. TEACHER

Date:...................... Department :- EDUCATION DEPARTMENT


Note: Please sign each page of the declaration. Asset declaration form must be
in A4 size white paper with computer typed (single side) in prescribed
format.

You might also like